How much rates vary
Facilitymedian $1,950 · 10th to 90th $100 to $4,571Professionalmedian $240 · 10th to 90th $91 to $363
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $100.00 Median $2,951.21 Typical High $4,570.88 | Facility | None | $100.00 | $2,951.21 | $4,570.88 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $338.84 | Professional | None | $79.43 | $194.98 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $316.23 Typical High $323.59 | Facility | None | $302.00 | $316.23 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $239.88 Typical High $371.54 | Professional | None | $91.20 | $239.88 | $371.54 |
Molina Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | None | $213.80 | $257.04 | $309.03 |
Regence BlueShield Setting Facility Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $3,548.13 | Facility | None | $1,905.46 | $2,454.71 | $3,548.13 |
Regence BlueShield Setting Professional Modifier None Typical Low $95.50 Median $338.84 Typical High $398.11 | Professional | None | $95.50 | $338.84 | $398.11 |
Select Health Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Select Health Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $537.03 | Professional | None | $81.28 | $131.83 | $537.03 |
U of Utah Health Plan Setting Professional Modifier None Typical Low $87.10 Median $331.13 Typical High $549.54 | Professional | None | $87.10 | $331.13 | $549.54 |
United Setting Facility Modifier None Typical Low $302.00 Median $1,698.24 Typical High $4,677.35 | Facility | None | $302.00 | $1,698.24 | $4,677.35 |
United Setting Professional Modifier None Typical Low $72.44 Median $177.83 Typical High $371.54 | Professional | None | $72.44 | $177.83 | $371.54 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $50.12 Median $109.65 Typical High $138.04 | Professional | 52 · Reduced service | $50.12 | $109.65 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $43.65 Typical High $54.95 | Professional | 53 · Discontinued | $19.95 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $162.18 Typical High $208.93 | Professional | 54 · Surgery only | $75.86 | $162.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $32.36 Typical High $41.69 | Professional | 55 · Aftercare only | $15.14 | $32.36 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $21.88 Typical High $27.54 | Professional | 56 · Pre-op care only | $10.00 | $21.88 | $27.54 |
Where Utah sits
The same service costs 9.0 times more in Colorado than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
CO $4,579MT $507
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.